Helen Farabee Centers Board of Trustees Minutes - 06/01/2006 HELEN FARABEE REGIONAL MHMR CENTERS
BOARD OF TRUSTEES i
• ,v.r. June 01,2006
11:00 AM
Staley Conference Room
500 Broad
Wichita Falls,Texas
Board of Trustee Ken Andrews, Chair; Robert Clement; Bill Coombs, Vice-Chair; Michael
Members Present: Ezell; Jo Ann Marquart; Bobby McGough; Sue Nunn, Secretary/Treasurer;
Shelley Owen; Bobby Smith
Board of Trustee None
Members Absent:
Senior Roddy Atkins, Executive Director; Rod Brennan, Chief Financial Officer; Jeff
Management Staff Dresbach, Human Resources and Risk Management Director; Lynn Hartje,
Present: Mental Health Services Network Director; Connie Johnston, Community and
Consumer Support Director
Other Staff and The Honorable David Farabee,Texas House of Representatives District 69;
Guests Present: Andy Martin,Utilization Management; Jerrie Sowards,Representative David
Farabee's Office; Jan West, Administrative Assistant/Board Liaison, Recorder
AGENDA TOPICS
060106-1 CALL TO ORDER
, Judge Andrews called the meeting to order in open session at 11:05 AM. A quorum of Board of Trustee
members was present.
Robert Clement; Michael Ezell; Shelley Owen; and Bobby Smith were not present when the meeting
was called to order.
060106-2 PRESENTATIONS
A) Open Citizen Comment to the Board
No citizen comment was offered.
B)Introduction of Guests
The Honorable David Farabee,Texas House of Representatives District 69 and Jerrie Sowards,
Representative David Farabee's Office arrived later in the meeting and were introduced as guests.
060106-3 APPROVAL OF MINUTES
The Board of Trustees approves the minutes of the May 04, 2006 Board of Trustees meeting.
Motion: Mr. McGough Affirmative: 4
Second: Ms. Nunn Negative: 0
Citizen Comment:None
060106-4 TRAINING
A) Community and Consumer Support
Connie Johnston, Community and Consumer Support Director presented the Community and Consumer
Support training(on file).
11:10 AM Shelley Owen and Bobby Smith arrived at the meeting
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060106-5 RECOMMENDATIONS
A. BOARD OF TRUSTEES
No Agenda Items
B. BUDGET AND FINANCE
1) Financial Statements
RECOMMENDED ACTION: That the Board of Trustees approve the financial statements for April 2006.
Rod Brennan, Chief Financial Officer presented the financial statements for April 2006 (on file).
The Board of Trustees approves the financial statements for April 2006.
Motion: Ms. Nunn Affirmative: 6
Second: Mr. Coombs Negative: 0
Citizen Comment: None
THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:50 AM AND WAS
RECONVENED BY JUDGE ANDREWS AT 12:15 PM
12:15 PM Robert Clement, Bill Coombs, and Michael Ezell, and were not present when the meeting
reconvened.
2)Auditor's Letter of Engagement
RECOMMENDED ACTION:That the Board of Trustees accept the attached Letter of Engagement from
Scott, Singleton,Fincher and Company and authorize the Chair to sign the letter.
Rod Brennan, Chief Financial Officer presented the Letter of Engagement from Scott, Singleton,Fincher
and Company(on file).
The Board of Trustees accepted the attached Letter of Engagement from Scott, Singleton,Fincher and
Company and authorized the Chair to sign the letter.
Motion: Ms. Owen Affirmative: 5
Second: Mr. Smith Negative: 0
Citizen Comment: None
C. CONTRACTS AND PLANS
No Agenda Items
12:20 PM Bill Coombs returned to the meeting
12:22 PM Robert Clement and Michael Ezell arrived at the meeting
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June 01,2006
D. FACILITIES AND EQUIPMENT
1)Remodel Entrance at Broad Avenue Facility
RECOMMENDED ACTION: That the Board of Trustees approve the remodeling of the Broad Avenue
facility at a cost not to exceed $77,821 and architectural fees not to exceed$7,004.
Rod Brennan, Chief Financial Officer presented the architectural fees and bids for the remodeling of the
Broad Avenue facility(on file).
The Board of Trustees aproved the selection of Chavez Contracting, the lowest bidder for the remodeling of
the Broad Avenue Facility at a cost not to exceed$77,821 and the architectural fees from Staley,Baker and
Monson of$7,004.
Motion: Ms. Marquart Affirmative: 8
Second: Mr. Coombs Negative: 0
E. POLICIES AND PROCEDURES
No Agenda Items
12:35 PM Jo Ann Marquart left the meeting
F. PROGRAM AND PERSONNEL J
1) Psychiatrists'Employment Agreements
RECOMMENDED ACTION: That the Board of Trustees approve the use of Employment Agreements in
the recruitment,hiring and management of Psychiatrists employed with Helen Farabee Regional MHMR
Centers.
Jeff Dresbach, Human Resources and Risk Management Director presented the information on using
Employment Agreements in the recruitment,hiring and management of Psychiatrists employed with Helen
Farabee Regional MHMR Centers(on file). He asked that item A.under Background Information be
changed to"The basic Employment Agreement and management process will be established in Policy and
presented to the Board of Trustees for approval prior to the execution of any agreements." This will comply
with current Policy that the Board of Trustees does not approve procedures.
The Board Of Trustees approved the use of Employment Agreements in the recruitment,hiring and
management of Psychiatrists employed with Helen Farabee Regional MHMR Centers.
Motion: Mr. Smith Affirmative: 7
Second: Mr. Ezell Negative: 0
Citizen Comment: None
12:40 PM Jo Ann Marquart returned to the meeting
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060106-6 QUARTERLY REPORTS
A. PLANNING AND NETWORK ADVISORY COMMITTEE
1) Third Quarter Report
RECOMMENDED ACTION: Information item only.
Connie Johnson, Community and Consumer Support Director presented information on the third quarter
activities of the Planning and Network Advisory Committee(on file).
No action required, for information only.
Citizen Comment: None
B. MANAGEMENT REPORTS
1)Essential Services and Clinical Accountability
RECOMMENDED ACTION: Information item only.
Andy Martin,Utilization Manager went over the Essential Services and Clinical Accountability Report
(on file).
No action required, for information only.
Citizen Comment: None
060106-9 EXECUTIVE DIRECTOR'S REPORT
Physician Recruitment
As discussed in the previous agenda items, we are very tight on physician recruitment.
Adult Mental Health Services
In order to be in compliance with the Fidelity Review we have to do Resiliency and Disease Management
(RDM) and maintain caseloads. Resilience and Disease Management requires evidence based practices
which include training, supervision and functions. This requires a lot of staff time and energy. Since
implementation of Resiliency and Disease Management, most of the Centers have reduced the numbers
they have served. Our target is 1,928 and we are currently serving 2,316 in Adult Mental Health Services.
We are serving this number with our existing resources. We are going to be asked to beef up our Crisis
Services. We have clinicians with 251 on their case loads. We have limited physician resources. We can
not continue with the numbers we serve and implement Resiliency and Disease Management and Fidelity.
It is taking too much staff time and energy. The question is, do we keep the status quo or comply with
Resiliency and Disease Management and decreased the number served? Do we close the front door to
non crisis and implement waiting lists? We may bring this back as an agenda item. Sanctions will result
in permanent reductions in funding. This puts pressure on our system as there is no new dollars. How
do we address the sanctions and still serve the people. We no longer have a place to come up with the
money. We started the merger with 454 employees; we are now at 243 employees.
Shelley—We need to address whether we want to continue with our current profit margin or add
additional staff. I recommend that we have an agenda item to address Waiting Lists.
Roddy—Most Centers have Waiting Lists, I do not know how to avoid it any longer.
Robert—We need to be fiscally sound and avoid dangerous sanctions.
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June 01,2006
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Roddy—We are considered a high funded Center because of the equity issue. We can only do the best we
can,but you need to understand we can not do all we use to. We have been gong out of our way to get
people into services. Our staffs are stretched thin, they are tired, and it is a tough job. This is the issue we
are wrestling with. The waiting lists will be in Graham, Bowie, Decatur, and Wichita Falls because that is
where the demand has sky rocketed. We will have to determine capacity in all areas including the rural
areas.
Bill—The problem is if we do not deal with them at the front door, we will eventually have to deal with
them as an emergency.
Roddy—We are facing some of the same issues with our Mental Retardation Services General Revenue.
We are still losing money on the Texas Home Living Waivers.
Robert—What is the larger money crisis, state hospital utilization or the front door?
Lynn—It is a testable reality that the sooner we can get the patients in and stabilized the more optimal the
benefits. The potential for maximum benefit is lost with each recycle.
Roddy—We really can not predict for awhile what the consequences will be.
Jo Ann —But we can not burn our employees out.
Roddy—We have to decide if we want to provide quality services versus just seeing everybody. With the
current stretch, I am not sure how well we are executing treatment by just trying to keep the doors open.
Robert—Perhaps we need to close the front gate and monitor.
Andy—There is a state procedure for waiting lists that include a monthly evaluation. Be aware that
waiting lists do not include Medicaid.
Roddy—The state has a set policy and procedure in their Performance Contract requirements.
Jo Ann —As usual they leave out the working poor. This is a political issue.
Bill—How do we make this understandable to our communities? Eventually they will come to our doors
for answers.
Robert—If we can set capacity guidelines for each facility, then we need to get it on the agenda for our
next meeting and come with comprehensive analysis and data so we can make an informed decision.
Michael—Do you have an Employee Appreciation Day?
Jeff—Last year during Open Enrollment we had an Employee Appreciation Day in which we cooked
hamburgers, invited vendors to set up booths, etc. We have one tentatively scheduled for this July.
Lynn—The reality is we assess capacity continually,but there are so many variables. We can come up
with the data,but we may or may not be able to give you the data sufficient or clean enough to not have a
nagging doubt. It is a give and take with the negative outcome, not an easy decision.
1:40 PM Jo Ann Marquart left the meeting
Robert—Maybe we need to monitor and prioritize those for waiting list.
Roddy—At least 60% of the folks on the waiting list will have a Depression diagnosis. That is the
diagnosis we anticipate will be on the waiting list.
Rod—The answer to your question is no, we can not provide you with all the data to make a decision by
next meeting. There are a lot of parts involved. We might be able to provide you with a part each month.
Robert—Then keep us appraised. We will be ready to discuss. We have to look at our fiduciary
responsibilities and minimize the effect of the down size on our consumers.
Michael—Am I hearing that what we want to look at you can not provide?
Jeff—On the staff end, in the outlying areas they are busting it because of the number of employees.
Yesterday we were authorized to introduce two new positions which will help.
Roddy—If you are asking if we are at a black and white point,No, and we probable never will be.
Bobby Smith —What we need to do is provide you with some guidelines and allow you to make the
decision.
Roddy—We are going to be required to shift more funds and energy into crisis,which means we are
going to have to rob Peter to pay Paul. The message from the state is Do Not Over Serve! They will be
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June 01,2006
requiring us to upgrade Crisis Services whether they pay us or not. As I begin to shuffle the deck I want
you to know the potential results as I have to move resources. You need to understand that this will result
in our not being able to provide services to the numbers we are currently serving. Based on my 26 years
of experience, we will have to decrease the numbers we serve. I do not want the Board of Trustees to be
ignorant of why these decision are being made and am looking for guidance from the Board of Trustees.
060106-8 CLOSED SESSION
In accordance with Chapter 551.074 of the Government Code, the Board of Trustees will now meet
in closed session for the purpose of discussion of personnel matters.
Review and Discussion of Executive Director Evaluation
060106-9 OPEN SESSION
No action was taken in Closed Session.
Request Agenda Item at next meeting to discuss Executive Director's Contract of Employment and
Performance Evaluation format.
060106-10 ANNOUNCEMENTS
A. Facility Tour Following Meeting
Mr. Atkins announced the tour of the Broad Avenue Facility.
B. Next Meeting
The next meeting is scheduled for 11 AM, Thursday, July 06, Child and Adolescent Services at 516
Denver in Wichita Falls.
Motion was made to not hold the July meeting due to the Annual Trustee Training that is being held June
28th, 29`'', and 30t.
The Board Of Trustees approved the cancellation of the July 6th meeting.
Motion: Ms. Owen Affirmative: 7
Second: Ms. Nunn Negative: 0
Citizen Comment: None
060106-11 OTHER BUSINESS
None
060106-12 ADJOURN
The Board of Trustees' meeting adjourned at 2:20 PM.
Approved as presented: Approved as corrected:
August 10, 2006
Board of Trustee Meeting Minutes 6
June 01,2006
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A)0 HELEN FARABEE
! •p REGIONAL MHMR CENTERS
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P. O. Box 8266 500 Broad Street Wichita Falls,Texas 76307-82(
Phone (940) 397-3300 Fax (940) 397-33';
August 14, 2006
Darron Leiker
City Manager
City of Wichita Falls
P.O. Box 1431
Wichita Falls, Texas 76307-1431
Dear Mr. Leiker:
In accordance with the provisions of Senate Bill 112, a copy of the minutes of the Board of
Trustees of Helen Farabee Regional MHMR Centers is enclosed for the regularly scheduled
meeting held on June 01, 2006. These minutes were approved by the Board at its meeting held
on August 10, 2006.
Sinc 1 ,
A641—
Jan W
Admi istrative Assistant/Board Liaison
/jw
enclosure
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